AUGUST 11, 2016 – TORONTO – The Ontario Stroke Network is pleased to announce the release of the Community Stroke Rehabilitation Models in Ontario resource.

This project was undertaken to amalgamate the knowledge and lessons learned from the development, implementation, and successes of existing and emerging programs in an attempt to inform and guide development of future models.

The Community Stroke Rehabilitation Models in Ontario resource is designed to inform health system planners, hospital and Community Care Access Centre directors, Ministry of Health and Long Term Care bodies, Local Health Integrated Networks, and other individuals working within the stroke system how to achieve best practices as outlined in the 2015 update of the Canadian Best Practice Recommendations Managing Stroke Transitions of Care
Resources, knowledge, and information on existing programs were brought together to develop the Community Stroke Rehabilitation Models in Ontario resource. Program structures, elements, challenges, and successes, were examined and summarized in an effort to help inform the development, and ensure the success of, future community based stroke care models.

This resource can be accessed on the Ontario Stroke Network website.

The Canadian Best Practice Recommendations Managing Stroke Transitions of Care module, based on the growing and changing body of research evidence, guides the ongoing screening, assessment, and management of patients who have experienced a stroke, their families and their caregivers. Its goal is to ensure patients move from each stage of care to the next without falling through the cracks or getting lost out of the system.

Transitions of care are defined as the movement of patients between healthcare providers, goals of care, and healthcare services. The recommendations’ general principles are that the goal of transition management is to facilitate and support seamless transitions across the continuum of care, and to achieve and maintain optimal adaptation, outcomes, and quality of life for patients, families, and caregivers following a stroke. This includes physical, emotional, environmental, financial, and social influences. In this context caregivers are informal, unpaid family and friends who participate in care activities with someone who has had a stroke.

The updated Managing Stroke Transitions of Care recommendations are published in the International Journal of Stroke and are part of the fifth edition of the Heart and Stroke Foundation Canadian Stroke Best Practice Recommendations. The supporting resources, including rationale, system implications, performance measures, and implementation are available online.

Taking Action for Optimal Community and Long-Term Stroke Care: A Resource for Healthcare Providers (TACLS) is an evidence-based resource closely linked with Canadian Stroke Best Practice Recommendations.

To obtain updated recommendations click here for IJS publication: